Predictive value of thrombus characteristics on recanalization rate and clinical outcome in acute posterior stroke patients receiving endovascular therapy

Acute occlusion of the basilar artery (BAO) is a devastating disease, resulting in really high fatality and morbidity if untreated. Historically, Endovascular therapy (EVT) has been the treatment of choice. However, in contrast to the anterior circulation, the optimum treatment strategy for BAO has not been validated in randomized controlled trials since very few patients with BAO have been included in intravenous thrombolysis (IVT) trials. Most of our knowledge on the efficacy and safety on IVT in BAO stems from very few centers routinely performing IVT in these patients. More recently, five randomized controlled trials demonstrated the safety and effectiveness of EVT in patients with anterior circulation stroke. BAO patients again had been almost completely excluded. Whether EVT is the prime treatment strategy for BAO is still uncertain. In the past decades, neuroimaging factors have taken on an important role in determining efficacy of different strategies of treatment and predicting clinical and radiological outcome in stroke patients. Since most of the studies have been performed in patients with anterior circulation stroke data on BAO patients is scarce. The aim of this study was to evaluate the prognostic value of thrombus characteristics in patients with BAO. Therefore, we aimed to evaluate the prognostic value of thrombus characteristics, including thrombus length and thrombus density, regarding recanalization rate and outcome in BAO patients treated with EVT